1. Introduction
To facilitate blood circulation in the failing heart, the left ventricle assist device (LVAD) was developed and used as destination therapy. The LVAD is an alternative to heart transplantation and can be a bridge to recovery or a bridge to heart transplantation 1-3 in patients with left ventricular failure. The use of LVADs prolongs survival in patients with heart failure 3. In Japan, LVADs became a health insurance option for patients on the heart transplant waiting list in 2011. However, the number of patients on the transplant waiting list and, consequently, the number of patients with LVADs is increasing due to the continuing shortage of donor hearts3-5. Adequate anticoagulation is essential in patients with LVADs, as clots inside the LVAD can be fatal. However, anticoagulation can lead to intraoperative and postoperative bleeding when patients with LVADs require surgery.
Acute cholecystitis is a common abdominal condition that requires urgent intervention. Several reports describe the use of endoscopic surgery to treat cholecystitis in patients with LVADs 6 7. Here, we report the use of percutaneous transhepatic gallbladder drainage (PTGBD) to relieve local inflammation due to acute cholecystitis in a LVAD transplant recipient with unstable vital status. The PTGBD was followed by an elective laparoscopic cholecystectomy (LC). An intraoperative video is provided (Additional File 1: Video S1).